Наш досвід застосування реберного трансплантата при закритій і відкритій риносептопластиці у пацієнтів з сідловидною деформацією носа внаслідок травм, отриманих під час участі в операції Об’єднаних сил

Abstract

SummaryAim. To compare the closed and open surgical method of correction of saddledeformity of nose (SDN) according to our own experience, to determine the possibilitiesand effectiveness of rib autografts (RA) to eliminate SDN in functional rhinoseptoplasty(RSP) in servicemen of the Armed Forces of Ukraine.Materials and methods. RA was used in five cases of SDN patients. Threeoperations at SDN were performed according to the closed method (main group), twooperations were performed according to the open method (control group). All patientswere male. The average age of patients in the main group was (35±7.1) years, thecontrol group was (32±6.3) years, and the age difference was not statisticallysignificant. An area of the right 6th costal cartilage was used for reimplantation in allpatients, as first stage of the operation classic endoscopic septoplasty with laser lowerturbinoplasty was performed.Results and discussion. The aesthetic shape of the nose was achieved in all patientsof both groups, the function of nasal breathing was restored. Everyone’s wounds healedwith primary tension. Reactive, soft tissue edema regressed faster with the closedmethod, the rehabilitation period was reduced by (19±2.1) days in the main groupcompared with control patients (p<0.05). Among the patients of the main group, two(66.7%) were satisfied with the result, and 1 patient (33.4%) was partially satisfied dueto the discrepancy between the result and his own expectations. From control group 1patient (50%) was not satisfied with the result.Conclusions. SDN is a complicated pathology that requires the qualification of asurgeon and material for implantation. Closed RSP with implantation of the patient’sRA has advantages over closed. Good cosmetic and functional results allow servicemento perform their duties well, maintain physical condition at the appropriate level, reducethe incidence of comorbidities, be fit for military service in special units, reduce the riskof psychological disorders.